C7A.093
BillableMalignant carcinoid tumor of the kidney
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is C7A.093 an HCC code?
Yes. C7A.093 maps to Lymphoma and Other Cancers under the CMS-HCC V28 risk adjustment model (and Breast, Prostate, and Other Cancers and Tumors under V24).
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
MEAT Criteria for C7A.093
For C7A.093to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically — it has to be re-documented and supported each calendar year.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed C7A.093 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
C7A.093 is the ICD-10-CM diagnosis code for malignant carcinoid tumor of the kidney. A rare type of cancer that starts in hormone-producing cells of the kidney, growing and spreading to other parts of the body. This is a malignant (cancerous) neuroendocrine tumor that requires immediate treatment. C7A.093 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering malignant neuroendocrine tumors (c7a).
Under the CMS-HCC V28 risk adjustment model, C7A.093 maps to Lymphoma and Other Cancers (HCC 21) with a community, non-dual, aged base RAF weight of 0.671. Under the older CMS-HCC V24 model, C7A.093 maps to Breast, Prostate, and Other Cancers and Tumors (HCC 12) with a community, non-dual, aged base RAF weight of 0.150. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.
Verify documentation specifies the tumor is malignant and located in the kidney; carcinoid tumors can occur in multiple sites and require site-specific coding. Because C7A.093 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for C7A.093 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify documentation specifies the tumor is malignant and located in the kidney; carcinoid tumors can occur in multiple sites and require site-specific coding
- •Ensure the neuroendocrine nature is documented; if metastatic disease is present, code the secondary sites separately using C7A codes or C80 codes as appropriate
Clinical Significance
Malignant carcinoid tumor of the kidney is an exceptionally rare neuroendocrine malignancy, with fewer than 100 cases reported in the literature. Renal carcinoids must be distinguished from the far more common renal cell carcinoma. These tumors can produce vasoactive substances and may present with carcinoid syndrome, though this is uncommon in renal primaries. The rarity of this diagnosis necessitates careful pathologic confirmation.
Documentation Requirements
- ✓Pathology report with immunohistochemical staining confirming neuroendocrine differentiation (synaptophysin, chromogranin A positive)
- ✓Distinction from renal cell carcinoma, collecting duct carcinoma, or metastatic neuroendocrine tumor to the kidney
- ✓Laterality (right or left kidney)
- ✓Tumor size and staging
- ✓Presence or absence of metastatic disease at other sites
- ✓Treatment plan and surveillance protocol
Commonly Confused Codes
- •C64.9 — Malignant neoplasm of unspecified kidney: Use for renal cell carcinoma and other non-neuroendocrine kidney cancers
- •C7B.09 — Secondary carcinoid tumors of other sites: Use when carcinoid from another primary has metastasized to the kidney rather than a primary renal carcinoid
- •D3A.093 — Benign carcinoid tumor of the kidney: Use only for confirmed benign neuroendocrine tumors of the kidney